On the verge of historic reform, CMS still has no chief

Passing a bipartisan health reform package is only the first hurdle. Implementing it will be a herculean leap, especially since CMS is still without an administrator.

When appointed, the new CMS leader "will have to learn the workings of an agency that oversees a budget $200 billion larger than the Pentagon's," New York Times economic columnist David Leonhardt writes in a piece that calls President Obama to task for failing to appoint a Medicare chief. "And finally there will be the small matter of helping to oversee big chunks of the most ambitious domestic policy legislation in decades."

Implementing the myriad, complex programs and policy changes will require a leader with a full grasp of CMS's inner workings.

"[T]he lack of a Medicare nomination suggests that the White House is not giving enough attention to what will happen once Mr. Obama signs a bill," he writes. "Within months, Medicare will need to begin creating pilot programs meant to reduce wasteful care and reward good care. Medicaid will have to plan a huge expansion. The independent Medicare oversight board will have to be formed. The federal government, or perhaps every single state, will need to start creating an insurance exchange."

For more information:
- read Leonhardt's column